This project will pursue a coordinated set of activities to build a multi- institutional and inter-disciplinary research program in patient safety. Its long-term objective is to provide the methodologic and logistic infrastructure for multiple future research projects that share the theme of patient safety. The project will be conducted in two phases. The specific aims of Phase I are: 1) Build an interdisciplinary research team that has sufficient commitment and diversity of expertise to develop and carry out collaborative research projects on patient safety; 2) Develop effective working relationships between the research team and clinical systems staff at multiple large health care organizations, as to permit creation of a research agenda on patient safety that promotes collaboration among the participating organizations; 3) Provide state of the art training on patient safety to research team members, clinical executives and key managers at the participating health care organizations, as to stimulate development of patient safety improvement systems and data sources; 4) Develop data systems on medical errors at multiplier large health care organizations that will serve as a resource for future research projects; and 5) Construct a detailed research agenda that builds upon local data sources and permits writing scientifically valid proposals for future research in the domain of patient safety. The specific aims of Phase II are: 1) Carry out a pilot project that provides useful new information on patient safety and demonstrates the ability of the research team to work together collaboratively; 2) Identify and develop common data elements on medical errors at the participating organizations, with the potential for future initiatives to compare experiences among the organizations and pool data on patient safety; 3) Develop at least two complete proposals for future research on patient safety that are competitive for peer reviewed funding support. The project will include a core team of seven investigators who will meet weekly to carry out the developmental activities. Team members will have designated links to the five participating large health care organizations and will meet regularly with clinical and quality management staff to identify data sources and to promote systems to identify safety vulnerabilities. Formal training on patient safety will be conducted through collaboration with the VA National Center for Patient Safety. A steering committee comprised of leaders of the five participating organizations and other selected experts will meet quarterly to provide oversight and guidance to the project.